從社會與教育制度看台灣醫師人才的培養

Social and Educational Aspects Concerning the Development of Physicians in Taiwan

楊明仁(Ming-Jen Yang) ； 蔡瑞熊(Juei-Hsiung Tsai)

《Journal of Medical Education》 1卷2期 (1997/06) Pp. 21-28

https://doi.org/10.6145/jme.199706_1(2).0004

摘要

醫學敎育是一種專業養成，而其之所以不同於其他行業或職業訓練，最主要的是醫療專業不僅有獨特的知識理論體系，且還有嚴格的倫理規範。而其與社會變遷、醫療制度、證照檢覈考核、以及科技發展等等問題相互糾葛更是錯綜複雜，然若不能以宏觀的角度進行探討必難窺全貌。本文將針對下列幾點來討論：
1．社會與敎育制度，如實習醫師制度的問题、國家醫師證照檢覈考試、健保給付制度對醫師培育的影響、敎學醫院評鑑對醫師培養方向影響的問題。
2．醫師是否將醫療行為從個人生理的照顧延伸到心理或社會層面的關懷。
3．醫師是否養成終身敎育的能力，並積極參與各種正面社會活動的責任感。
醫學敎育應不只沈溺於西方科技的敎授與典章制度的移植，更不只是專業知識的傳授、對疾病本身的解決，而是心理、倫理、社會、經濟面的關懷及加強對本土醫療與文化的省思。

關鍵字

社會變遷 ； 醫學教育 ； 醫師人才培養

並列摘要

Along with its rapid social changes, the issue of medical education is also experiencing inevitable evolutionary hardships in contemporary Taiwan. Especially, the development of physicians is also crucial and should not be disregarded. In this sense, we highlighted and elaborated on the following significant issues and applied them as reference points for future discussions.
1. The development of physicians being most likely influenced by the interactions of social changes, political economy, bureaucratic regulations, and innovations of high technology is inevitable. Thus, we would like to discuss: 1) the pros and cons of taking the National Board Examination before internship; 2) the influence of National Insurance Policy on the training of physicians; 3) the influence of various board examinations on the developmental directions of physicians; 4) the influence of teaching hospitals' accreditation system and review criteria on the development of physicians.
2. The deterioration and attenuation of both the doctor-patient relationship and medical ethics in our society are reputed to be attributable to the lack of psychosocial concerns in medical care. Thus, our discussion would help to rethink the possibilities of diverting the orientation of medical care from a biochemical approach to a more humanistic bio-psycho-social model.
3. How to encourage medical professionals to pursue lifelong educational goals and further, to broaden their social participation thereby helping to fulfill social responsibilities merited discussion.
Finally, we propose the purpose of this article is to point out that this is only a 'tip of the iceberg' effect. Therefore, it is subject to further discussion.

並列關鍵字

social changes ； medical education ； development of physicians